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pdfOMB Control Number: 0584-0474
Expiration Date: 9/30/2015
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for this information collection is 0584-0474. The time required to complete this information collection is estimated to average 63 minutes per response, including the time for reviewing
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Site Name
Site Status
(Open, Closed,
Camps, Migrant)
FNS-543A (04-15) Previous Editions Obsolete.
Site Address 1
Site Address 2
SBU
Site City
Site
State
Site Zip
Site Phone
Ext
Electronic Form Version Designed in Adobe 10.0 version
Contact
First Name
Contact
Last Name
Contact Phone
Sponsoring Organization
Start Date
End Date
Days of Operation
Breakfast
Time
Lunch
Time
Snack
Time
Dinner/
Supper Time
| File Type | application/pdf |
| File Title | FNS-543A |
| File Modified | 2015-08-12 |
| File Created | 2015-04-14 |